Microendoscopic Surgery Offers Alternative for Spine Patients

At Brigham and Women’s Hospital, spine surgeon Andrew Simpson, MD, focuses a large portion of his practice on microendoscopic spine surgery, a minimally invasive technique used to treat patients with a range of spinal disorders—including disc herniation, spinal stenosis and sciatica.

The incision used in the innovative procedure is small enough to be covered with a Band-Aid, and most patients return home the same day of their operation. And yet, the procedure has been slow to take off in the United States.

“Only a handful of surgeons offer microendoscopic spine surgery in the US, so we’re ahead of the curve,” said Dr. Simpson. As the Brigham’s Director of Minimally Invasive Orthopaedic Spine Surgery, he’s focused on making sure that spine patients have access to less-invasive solutions, especially if it makes for a faster recovery with fewer complications. “We want to get patients over their spine problem and back to their lives as soon as possible.”

To learn microendoscopic surgery, Dr. Simpson traveled to Japan several years ago to study with two pioneering spine surgeons at Wakayama Medical University—Munehito Yoshida, MD, PhD, and Akihito Minamide, MD. Upon his return to the US, Dr. Simpson was determined to build his practice around the emerging technique.

“I’ve trained with some of the best spine surgeons on the planet, but when I saw what these talented Japanese surgeons could achieve working through a tiny tube, I knew microendoscopic surgery was the next step for spine surgery,” said Dr. Simpson. “It’s the kind of spine surgery I’d want for myself.”

Microendoscopy involves placing a small tube, with a diameter smaller than a dime, through a one-half inch incision. A 4-mm hi-vision fiberoptic camera is then fed into the tube and specialized instruments are used to remove disc material and bone spurs that compress nerves in spine conditions such as stenosis and disc herniation.

By working through such a small space, microendoscopic spine surgery achieves the same goals of conventional spine surgery, but causes less damage to muscles and ligaments and other supporting structures of the spine. As a result, patients who undergo microendoscopy experience lower complication rates, less pain, and faster recovery. Most patients return to work within a week or two.

In his experience, most of Dr. Simpson’s patients are delighted to learn of microendoscopic surgery, which allows them to avoid fusion procedures and more invasive operations, and the potential complications associated with traditional approaches.

“Increasingly, patients are demanding less invasive ways to treat their spinal disorders. We want to offer our patients the kind of state-of-the-art, evidence-based procedures that we would want for ourselves,” said Dr. Simpson.